They told her the lump on her chest was "probably just a cyst." But Christina Trieweiler Schmidt pushed for a diagnosis — and saved her own life

Most 26-year-old women do not have this sort of story to tell. Not when they are the picture of health, born and bred on clear Montana air, with the sparkle in their eyes to prove it. Not when they balance life as a single mother and speech-language pathologist with running marathons, eating and living organically, and contributing to a small town — where they are loved and supported and live across the street from their parents. Most 26-year-olds with this sort of harmonious life do not face a devastating illness — nor do they need to become insistent on care that turns out to be lifesaving. But this one did.

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In September 2006, Christina Trieweiler was listening to a sermon in church as her 2-year-old daughter, Emma, rested her head against her chest. "I felt something — a small lump — just below my clavicle," she remembers. A few weeks later, during Emma's routine checkup, Christina showed the lump to their family doctor. "It's probably just a cyst," he told her, "given its location. But watch to see if it grows."

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It didn't get bigger, but the lump still nagged at Christina. She was also getting sick more often and feeling more tired than usual, but figured that was normal given her busy life.

Nearly a year later, while wearing a strapless dress, she caught a glimpse of the lump in an elevator mirror. "It's not right," she said to her boyfriend, Jason Schmidt, a family physician.

"If it bothers you, get it checked," Jason casually remarked.

The surgeon Christina saw was equally unconcerned, agreeing that the lump was likely a benign cyst. Still, he offered to remove it if she wanted him to; he warned, however, that she might not be happy with the scar. Christina didn't care about a scar. "I just want it out," she insisted.

The procedure took only a few minutes, during which the two of them joked about goings-on in their Montana valley. There was no reason for anyone to think the lump might be cancer, but Christina urged the surgeon to send the tissue sample to a pathology lab anyway. "I'm not sure why," she says now. "Maybe because I'm in the medical field." Or maybe it was intuition.

A SHOCKING REPORT

That was Wednesday, August 22, 2007. The following Monday, the surgeon called Christina at work. "I knew it couldn't be good news," she says. It turned out the growth wasn't a cyst at all, but an enlarged lymph node, the doctor said. She had cancer: Hodgkin's lymphoma.

"I was in shock," says Christina. She had to get out of the clinic, so she walked out to her car and, shaking, called her dad at his law office in downtown Whitefish. "I have cancer!" she cried. Her father, assuring her he'd be right there, left his office immediately, got onto the highway, and met her in the clinic's parking lot, about half an hour away from his office. "I can't even imagine what that drive was like for him," says Christina. In fact, she began to worry about all the people she loved — her parents, her two sisters, and Jason. Although they'd only been dating for six months, the relationship was getting very serious. But most of all, Christina's heart hurt for her daughter. She couldn't bear to think of leaving her little girl.

And so, for the next week, while her family and Jason operated in high gear, educating themselves about treatment and contacting everyone they knew with medical connections, Christina focused only on Emma. "I didn't want to miss a moment of the time we had," she says.

Briefly, Christina considered trying alternative treatments, too: helping to fight the cancer through diet changes or by seeing a healer a friend had mentioned. "But I was so scared; I just didn't have the emotional energy to look thoroughly into alternatives," she says. Plus, she just wanted to get rid of the cancer: "I'd had a scan, and I could see the tumors all the way down my sternum and along my clavicle and neck. And the cancer had been there for at least a year."

Something else happened, too, that put Christina off. She talked to one alternative practitioner about doing a cleanse, but felt the woman was blaming her for having gotten cancer: "That was the last thing I needed. We have no idea how I got sick. I thought it was terrible to imply it was something I'd done, especially since I was so young and had lived such a healthy life."

Having decided with Jason that she would go with conventional medicine exclusively, Christina also felt that she needed to seek advice from doctors outside her small community: "When you have an uncommon disease like this one, you need to go to a place where doctors see case after case."

So Christina got one opinion from a doctor in Seattle and another from Leo I. Gordon, M.D., director of the lymphoma program at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University in Chicago. Her local oncologist had laid out a treatment regimen that involved two cycles of chemotherapy, followed by a PET scan to check for tumors. If the scan was clear, then Christina would start radiation therapy; if it wasn't clear, she'd repeat the chemo-and — PET-scan cycle until the scan was negative, then proceed with radiation.

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But Dr. Gordon told Christina and Jason about new research showing that chemotherapy alone, at a higher dose and for six cycles, was just as effective as the chemo/radiation combination. Since patients who undergo radiation to the chest have a somewhat higher risk of later developing breast cancer and other health problems, avoiding radiation would be a big plus.

It would take two months to know whether the chemotherapy was working. If the tumors were responding, then Christina's survival odds would be 90% or better. But if not, the odds would be lower and she faced a higher likelihood of recurrence and the possibility of a bone marrow transplant with radiation. Nights were hard. "Sometimes I'd lie in bed with Emma, wanting to be close every moment, but then I'd realize it was important to keep things as normal as possible, and I'd make myself go back to my own bed."

There was another issue Christina had to deal with — the possibility of becoming infertile as a result of chemotherapy. "I really wanted another child," she says. Her chances of becoming infertile were under 20%, but her doctor suggested she take the drug Lupron, which causes the ovaries to temporarily shut down, possibly lessening the risk of damage.The side effects were awful, Christina says — like instant menopause: "I was moody. I couldn't sleep. I couldn't get through a conversation without sweat beads on my forehead."

That, coupled with nausea and vomiting from the chemo, left her feeling deeply ill for the first time in her very healthy life. Some people didn't know how to behave around her. "Here I was, bald, wearing a hat indoors, and someone would feel the need to tell me about every lump she'd ever had. Or about the person she knew who died of lymphoma."

But there were also the extraordinarily caring people. Christina would watch from her window — too weak to go out and say thank you — as her next-door neighbors cleaned her yard. Others left soup on her front porch. People sent fresh flowers from Hawaii and See's Candies from California. College friends flew in from around the country — New York, Illinois, Iowa, North Dakota — to sit with her during the long hours of chemotherapy infusions. And the nurses who administered the drugs, says Christina, were "angels."

Two months after beginning treatment, Christina received the good news that her tumors were responding. That made the next four months more bearable. During her last round of treatment, in February 2008, nurses rang cowbells in celebration, and another patient who was on the same chemo cycle brought in Champagne in a picnic basket. "It was the last thing I wanted," Christina says, "but there was no way I was going to pass it up."

Three weeks later, she learned that her PET scan was clear and she was officially in remission. She has been cancer-free since then, and if all continues to go well, next year Christina will reach the five-year mark. It's a happy ending by any account.

But this is not only a cancer story; it's also a love story. Shortly after she began treatment — before she even knew whether she was responding to the drugs — Christina and Jason went out for a drive. They were in Wyoming, visiting his parents over a cold Thanksgiving weekend, and he wanted to show her the mountain where he particularly loved to cycle. On the way up, Jason pulled the car over, telling her that something seemed funny with the right front tire. After poking around a little, he asked Christina to come out and look, too. She really didn't want to. She felt sick and was dressed in the warmest, softest clothes she had been able to find, but to please Jason, she got out. "There's something strange in the wheel well," he said. "Take a look." And while Christina humored him, feeling around in the dirt and slush, he said, "I found this in there." It was an engagement ring.

"To this day, I wonder what he was thinking," says Christina. "Proposing to a single mother with cancer — it's just not reasonable."

The wedding, alongside a lake at a guest ranch, took place the following August, just a year after Christina had wept to her father in her clinic's parking lot. She cried again as she helped Emma into her fuchsia dress, pinning a crown of pink flowers in her hair, and as she watched her friends who'd seen her through chemo, now in her wedding party; the nurses who'd been so caring; her parents and sisters; and finally Jason, who stood next to her high school chaplain as she walked down the aisle. "It was the best day of my life. We were celebrating our love, but we were also celebrating my life," she says.

And then, two months later, there was more happiness when Christina learned she was pregnant. A daughter, Vivian, was born July 20, 2009. Now Christina and Jason live with their two little girls in a house not far from where she grew up. "We are so blessed," Christina says. But she also sometimes thinks about how it all could have gone another, terrible way. Sometimes her doctor teases her, calling her "the woman who saved her own life."